The Challenge of Managing Crises
in a Rapidly Changing World
Dr. Stephen F. Lintner
Senior Technical Advisor, World Bank
and
President Elect, International Association for
Impact Assessment (IAIA)
XI International Health Impact Assessment Conference
Granada, Spain
April 2011
World Bank Group
• Founded 1944
• Over 185 Countries as Members Represented by a Board
of Executive Directors
• Headquarters in Washington, DC
• An Extensive Network of Offices Throughout the World
• Includes:
– International Bank for Reconstruction and
Development (IBRD)
– International Development Association (IDA)
– International Finance Corporation (IFC)
– Multilateral Investment Guarantee Agency (MIGA)
World Bank
• Focus on Poverty Reduction, including the
Millennium Development Goals
• Commitment to Environmentally and Socially
Sustainable Development, supporting outcome of
Rio and Johannesburg Summits
• Addressing Climate Change – both Mitigation and
Adaptation – as a Development Issue
Uses an Interdisciplinary Approach in Providing
Support for Policies, Plans, Programs,
Projects and Capacity Building
World Bank
• Since 1989 the World Bank has had a Board
Approved Policy on Environmental Assessment –
Including Project Related Health Impacts
• Making Extensive Use of Strategic Assessments
at Multiple Levels
• Process for Updating and Consolidation of
Policies in Process – Will Broaden Range of
Instruments – Including Specific Reference to
Health Impact Assessment as an Option
The Challenge of Managing Crises in
a Rapidly Changing World
• Facing a threefold global crisis:
– Economic
– Food
– Climate.
• Need to understand:
– Vital importance of inter-linkages among them
– Identify missed opportunities in putting these pieces
together
– Undertaking complementary proactive and preventive
measures
Health Sector
Fiscal Year 2011 Approved and Planned Health Sector
Support: US $ 3.1 Billion
• Child Health
• Communicable and Non-Communicable Diseases
Health System Performance
• Human Development
• Nutrition and Food Security
• HIV/AIDS
Malaria
• Tuberculosis
Complemented by National and Thematic Studies
Protecting Pro-Poor Health Services
During Financial Crisis
• Poor nutrition and lower level use of health care
when needed
• Women, children, poor and informal sector workers
are most at risk
• A special risk exists in many low-income countries in
maintaining access to essential health commodities
that are often imported
Protecting Pro-Poor Health Services
During Financial Crisis
• Real spending per capacity can decline due to
reduced revenues, currency devaluation and
potential reductions in aid flows
• Low-income Countries with weak fiscal policies are
most vulnerable
• Minimize adverse impact on health outcomes and
health expenditures
Protecting Pro-Poor Health Services
During Financial Crisis
• Broad strategies that maintain overall levels of
Government spending on health tend not be
successful, failing to protect access to quality health
services especially for the poor
• Targeted demand-side approaches like conditional
cash transfers may be more effective broader
approaches
• Import to make effective use of social safety net
programs which include support for nutrition and
health
•
Cost of Environmental Degradation
• 2000-2010: Cost of Environmental
Degradation (COED) in Algeria,
Egypt, Iran, Jordan, Lebanon,
Morocco, Syria and Tunisia
• Estimates the annual COED in
selected countries (% of the
countries’ GDP)
• Summarizes their impacts at
national and regional levels
• Training manual in French, Arabic,
English
Overview: Six Categories
• Agricultural Land - Agricultural productivity on
croplands and rangelands
• Forests - Wood, grazing, watershed protection,
biodiversity
• Water - Systemic impacts of water salinity,
contamination, sedimentation, groundwater
overexploitation
• Air Quality - Systemic impacts of air pollution on health
and environment
• Waste - Impacts of inappropriate waste collection on the
environment and public welfare
• Coastal Zone - Losses of recreational and landscape
value due to unsustainable coastal activities
COED Can Vary Substantially …
8
7.4
7
Coastal zone
Waste
4.8
5
Air
4
3.4
3
2.1
3.4
3.5
3.7
3.7
Land
2.4
Water
2
1
Iran
Egypt
Morocco
Algeria
Lebanon
(conflict)
Lebanon
Syria
Jordan
0
Tunisia
% of GDP
6
12
Tunisia - Cost of water degradation = 0.6%
of GDP
100%
90%
% of the total cost
80%
Health (18%)
70%
60%
50%
40%
Tourism (18%)
Groundwater
(21%)
30%
20%
10%
Agriculture
(33%)
0%
1.2% in Morocco, 2.8% in Iran
Impact on Investments
Algeria
• First Economic Recovery Program included institutional
reforms and pilot investments in the environment sector for
2001-2004 (US$450 million)
Egypt
• Second Pollution Abatement project to reduce pollution from
energy and industrial sectors (US$198 million)
Morocco:
• First Water Sector Development Policy Loan (US$100 million)
• Solid Waste Sector Development Policy Loan (US$132 million)
• Investments in pollution control in the Sebou basin (US$25
million)
Three Major Themes
• Integration
• Innovation
• Implementation
Importance of Addressing Both Major New
Challenges and Continuing Challenges
Information on World Bank Group
Environmental and Social
Safeguard Policies
• Safeguards Website
www.worldbank.org/safeguards
• Use of Country Systems Website
www.worldbank.org/countrysystems
• Strategic Environmental Assessment (SEA) Tool Kit Website
www.worldbank.org/seatoolkit
• IFC’s Sustainability Policy Framework
www.ifc.org
• Environmental Health and Safety
www.ifc.org/ifcext/enviro.nsf/context/EnvironmentalGuidelines
International Association for
Impact Assessment (IAIA)
• Annual Meeting – “Impact Assessment and Responsible
Development for Infrastructure, Business and Industry” –
Puebla, Mexico (May 28 – June 6, 2011)
• Special Symposium on SEA Implementation and Practice:
Making a Difference? – Prague, Czech Republic (September
21-23, 2011)
• Special Symposium on Climate Change and Impact
Assessment – Beijing, China (proposed for December 2011)
Contact: www.iaia.org
Contact
Dr. Stephen F. Lintner
Senior Technical Advisor
World Bank
1818 H Street, NW
Washington, DC 20433
USA
E-Mail: slintner@worldbank.org